From decision to action: Suicidal history and time between decision to die and actual suicide attempt

A substantial proportion of suicide attempts seem to be realized in a sudden manner. However, it is unclear how suicide attempters showing a rapid transition from the decision to die to acting differ from suicide attempters showing a slower transition regarding their suicidal history. The main aim of this study was to determine the proportion of suicide attempters, who reported a rapid transition (≤5, ≤10, ≤180 min) between their decision to die and their actual attempt. Furthermore, attempter groups (≤ vs. >5, ≤ vs. >10 and ≤ vs. >180 min) were compared regarding suicidal history (ideation, plans, and number of lifetime as well as 12 month suicide attempts) as well as depression, hopelessness and trait impulsivity. In total, 118 inpatients (62.7% female; age: M = 38.71, SD = 14.71) hospitalized due to a recent suicide attempt were assessed using structured clinical interview measures assessing suicidal history and self-report instruments. Thirty-six percent reported a time period of ≤5 min, 44% a time period of ≤10 min and 73% a time period of ≤180 min between their decision to die and their attempt. Participants with a rapid transition (≤5, ≤10, ≤180 min) did not differ from participants with a slower transition (>5, >10, >180 min) regarding suicidal history, depression, hopelessness and trait impulsivity. Taken together, a rapid transition seems common, but nevertheless, rapidly realized suicide attempts cannot necessarily be characterized as impulsive.